(Revised 7/10)
File Stamp Date
Case Number ________
Prepared by:
Filer’s name, SC#
Filer’s address
Filer’s phone number
{Filer’s fax phone number}
{Filer’s e-mail address}
Attorney for Judgment Creditor
In The District Court of ______ County, Kansas
Judgment Creditor name
Judgment Creditor
vs.
Judgment Debtor name
Judgment Debtor address
Case No. ______
Judgment Debtor
Garnishee name
Garnishee
Garnishee’s address
Garnishee’s county
{Garnishee’s fax phone number (if known)}
{Garnishee’s e-mail address (if known)}
Pursuant to Chapter 61 of
Kansas Statutes Annotated
Type of Service Requested: ___________________ by _____________________
ORDER OF GARNISHMENT
(To Attach Earnings)
To the above-named Garnishee:
The amount of the unsatisfied balance under this judgment, as of the date this Order is issued,
is:
$________________________________.
Complete the attached Answer under penalty of perjury as set forth in the instructions. The attached
Instructions to Garnishee are incorporated by reference. You are ordered as a garnishee to follow
the attached instructions as if they were set forth in this Order.
This order of garnishment has the effect of attaching the nonexempt portion of the judgment debtor’s
earnings for all pay periods which end while the order is in effect. The order takes effect the day
it is served on you. This order of garnishment is a continuing order and remains in effect until the
judgment against the judgment debtor has been paid or the garnishment is released, whichever
occurs sooner.
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This order also constitutes an order of the court directing the garnishee to pay to the judgment
creditor all earnings which are to be withheld under this order. You are ordered to withhold and pay
the earnings in accordance with the attached instructions.
If you fail to comply with the terms of this order and the attached instructions, the judgment creditor
may file a motion for judgment against you for the amount of judgment against the judgment debtor
or such other amount as the court shall order, including the expenses and attorney fees of the
judgment creditor. If you fail to make payment of funds as required under this order and the
attached instructions, the judgment creditor may file a motion for judgment against you for contempt
or such amount as the court shall order, including the expenses and attorney fees of the judgment
creditor.
Dated this _____ day of _______________, _____.
BY ORDER OF THE COURT
{If applicable, include the following:
This is a communication from a debt collector. This is an attempt to collect a debt and any
information obtained will be used for that purpose.}
RETURN ON SERVICE OF GARNISHMENT ORDER
I hereby certify that I have served this garnishment order in the following manner:
(1) Personal Service. By delivering a copy of the garnishment order along with two copies of the
answer form to each of the following persons on the dates indicated:
___________________ _______________, ______
___________________ _______________, ______
(Name)
(Date)
(2) Agent Service. By delivering a copy of the garnishment order along with two copies of the
answer form to each of the following agents authorized by appointment or by law to receive service
of process on the dates indicated:
____________________ _______________, ______
____________________ _______________, ______
(Name)
(Date)
(3) Service by Return Receipt Delivery. By causing to be delivered on the _____ day of
_______________, ______, a copy of the garnishment order along with two copies of the answer
form by return receipt delivery to each of the following persons at the following
address:_______________________________________________________________________
______________________________________________________________________________
_______________________________________________________________________________
with such delivery made by the following person or entity: _______________________________.
Attached hereto is a copy of the return receipt evidencing such delivery.
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(4) Return Receipt Delivery Refused. By mailing on the _____ day of _______________, _____,
a copy of the garnishment order along with two copies of the answer form to each of the following
persons at the following address:
(5) Mail Service. By mailing on the _____ day of _______________, ______, a copy of the
garnishment order, along with two copies of the answer form by first class mail to each of the
following persons at the following addresses:___________________________________________
______________________________________________________________________________
_______________________________________________________________________________
(6) Telefacsimile communication. By faxing on the _____ day of _______________, _____, at
____ o’clock _.m., a copy of the garnishment order, along with two copies of the answer form, to
t
h
e
f
o
l
l
o
w
i
n
g
persons:________________________________________________________________
Number of transmitting machine: _____________________
Number of receiving machine: ______________________
(7) Internet electronic mail. By e-mailing on the _____ day of _______________, _____, at ____
o’clock _.m., a copy of the garnishment order, along with a copy of the answer form, to the
f o l l o w i n g
p e r s o n s
a t
t h e
f o l l o w i n g
e - m a i l
addresses:_____________________________________________
______________________________________________________________________________
_______________________________________________________________________________
Transmitting person’s e-mail address: __________________________
(8) No Service. The following persons were not served:
______________________________________________________________________________
Pursuant to K.S.A. 53-601, as amended, I declare under the penalty of perjury that the foregoing is
true and correct.
EXECUTED on __________________, ______.
_______________________________
Signature, Sheriff or Process Server
Attach the following:
Instructions to Garnishee
Answer of Garnishee
Written Explanation
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